Diagnosing of cardio Flashcards
(93 cards)
1
Q
Bilateral peripheral edema
A
Diastolic congestive heart Failure
2
Q
treatment for Diastolic Heart Failure
A
IV, Oxygen for <94 monitors, diuretics furosemide (lasix) 40mg IV
3
Q
Mostly caused by viral infections in males <50 years old
A
Pericarditis
4
Q
A diffused ST elevation is a sign and symptom and an indicative of
A
Pericarditis and full tightness MI
5
Q
Pericarditis treatment
A
Aspiring 325-650 mg every 6 hours on schedule and NSIDS for 3 weeks, MEDADVICE
6
Q
upper respiratory infection
A
pericarditis
7
Q
What is becks triad and what is indicative of ?
A
Pericardial tamponade
Muffled heart sounds
Julgular venous distension
Hypotensive unresponsive to fluid challenge
8
Q
Sinus tachycardia is between ?
A
100-150
9
Q
pulsus paradoxus
A
10mmHg fall in SBP during inspiration, indicative of pericardial tamponade
10
Q
elevated cardiac enzymes will be an indicative of
A
mycarditis with pericarditis
11
Q
sound like velcro, crushing snow
A
pericardial friction rub
12
Q
bacterial or fungal infection of the valvular
A
endocarditis
13
Q
recreational IV drugs may indicate
A
endocarditis
14
Q
any new heart murmur with a fever is what until proven otherwise
A
endocarditis
15
Q
endocarditis TX
A
ertapenem 1 gram IV q 24hrs vancomycin 1 gram IV q 12 hrs ceftriaxone 2 grams IV daily MEDEVAC MEDADVICE
16
Q
Fever splinter hemorrhages janeway lesions osler nodes roth spots
A
endocarditis
17
Q
gold standard to evaluate for valvular vegetation?
A
Echocardiogram
18
Q
streptococci and aureus causes ?
A
endocarditis with sepsis
19
Q
myocarditis viruses
A
influenza, eptein barr, hepatitis B
20
Q
myocarditis bacteria
A
rheumatic fever
lyme
neisseria meningitides
21
Q
mycarditis non infectious causes
A
alcohol cocaine meds insect, snake bites IBS celiac
22
Q
retrosternal chest pain
A
mycarditis
23
Q
excessive fatigue or exercise intolerance
present S3/S4
pericardial friction rub
A
myocarditis
24
Q
treatment for myocarditis
A
AVOID NSIDS!!!
rest, fluid, pain control morphine
25
EKG for mycarditis
diffuse ST-segment elevation
26
```
crackles in bases of lung
pleural effusion
wheezing or rhonchi
decrease S1
murmurs
S3
hypoxemia
displaced apical impulse
```
Systolic CHF examination findings
27
Left side Systolic CHF physical findings
dyspnea
pulmonary edema
exercise intolerance
chronic no productive cough
28
treatment for CHF
IV, oxygen <94
| furosemide(lasix) 40mg IV 30 min repeat dose if inadequate urine output
29
bilateral peripheral edema
hepatic congestion
abdominal ascites
JVD
Diastolic (right side) CHF
30
EKG for Diastolic heart failure
AMI, arrythimia, or LVH
31
What is commonly caused by speed MVA?
myocardial contusion and necrosis
| can also cause Pericardial tamponade
32
commonly asymptomatic except for chest wall pain
broken ribs, chest wall contusion with ecchymosis
tachycardia dispropotinate to the degree of trauma
cardiac contusion
33
```
respiratory issues
tachynea
tachycardia
Hypoxemia
shortness of breath
Signs of DVT
```
Pulmonary embolism
34
Result for Pulmonary embolism Chest X-ray
CXR will be normal
35
What is the imaging study of choice for Pulmonary embolism
Helical CT pulmonary angiography
| also ultra sound to look for DVT
36
50-70 percent of pt with pulmonary embolism will also have
lower extremity DVT
37
What involves the virchow's triad
venous stasis
hypercoagulable state
injury to vessel wall
38
treatment for Pulmonary embolism
Oxygen
enoxaparin(lovenox) 1mg/kg SC q 12 hrs
heparin 80 units/kg IV loading dose, then initiate continuos infusion 18 units/kg/hr
39
trauma, recent travel, hormones treatment, recreational IV drugs, older than 60, birth control meds, surgery, smoking are sighs and symptoms of
DVT
40
unilateral swelling leg, pain redness and warmth to the touch and tenderness
DVT
41
what special test is unreliable sign for DVT
Homan's test
42
gold standard lab for DVT
ultrasound, you can also do d-dimer
43
treatment for DVT
enoxaparin (lovenox) 1mg/kg SC q 12 hrs
heparin 80 units/kg IV loading dose, then initiate continuous infusion 18 units/kg/hr
pain control with tylenol, morphine
long term anticoagulation 3-6 months minimum
44
condition as a result of increase vagal tone on normal pacemaker
organic disease of the SA note
medication with a HR than?
severe sinus bradycardia with a HR 45 bpm or lower
45
treatment for unstable sinus bradycardia
atropine 0.5 mg IV push and repeat every 3-5 min for a max of 3 mg
if ineffective consider trans-cutaneous pacing or dopamine infusion 2-20 mcg/kg/min or epinephrine IV infusion 2-10 mcg/min
46
unstable sinus bradycardia is define as
changes in mental status, ischemic chest discomfort, hypo-tension, sign of shock , acute heart failure
47
heart rate faster than 100 bpm, cause by rapid impulse formation from the SA node, the rate infrequently exceeds 150 beat/min P wave is followed by QRS and is of normal duration
SINUS tachycardia
48
Neurological deficit less than 24 hrs with carotid bruin
occlusive cerebrovascular disease
49
What other test we do to rule out differentials related to occlusive cerebrovascular disease ?
CT to the head to rule out/evaluate intracranial hemorrhage
| glucose to rule out hypoglycemia, aside from CBC, lipids, MRI the brain
50
phar and no phar treatment for cerebrovascular disease?
snon-phar: life style changes excersive, diet, smoking, weight lost
Phar: aspirin, statins for lipids, trombolitics, long term warfarin
surgical: endarterctomy
ballon angioplasty
51
chest pain, left shoulder pain, indigestion, nausea,/vomiting, pale, diaphoresis, new heart murmur, rales, s3/s4
CAD
52
treatment for CAD
life style changes
atorvastin(lipitor) 10 mg before bed time(max 80)
aspiring 80 mg daily
53
claudication (cramping pain in thigh, calf or foot with exercise, relieved by rest,.
diminished femoral, popliteal, or pedal pulses
erectile dysfunction, tissue ulcerations and gangrene
loss of hair, cooling and thinning of skin
atrophy of muscles
atherosclerotic peripheral vascular disease
54
symptoms for atherosclerotic peripheral vascular disease
claudication (cramping pain in thigh, calf or foot with exercise, relieved by rest,.
diminished femoral, popliteal, or pedal pulses
erectile dysfunction, tissue ulcerations and gangrene
loss of hair, cooling and thinning of skin
atrophy of muscles
55
Medication for peripheral vascular disease
cilostazol 100 mg PO BID
56
the 6 P's
Pain, pallor, poikilthermia, pulselessness, paresthesia, paralysis
57
sudden onset of extremity pain with reduction of pulse, neurological deficit, numbness or paralysis and the 6 P's
arterial, occlusion of a limb
58
treatment for arterial occlusion of a limp
enoxaparin (lovenox) 1mg/kg sc q12
heparin sulfate 5000-10000U IV stat
revascularization within 3 horus
59
layers of the pericardium and what follows to the innermost part of the heart
Pericardium (fibrous layer, parietal, cavity, epicardium or viseral layer)
mayocardium
endocardium
60
P's dont get through then you have mobits II
2nd degree AV block type II
61
Neumonic for risk factors for ischemic heart attach
| BAD HEARTS
```
BMI equal or greater than 30
Age 65 or older
Diabetics
HTN
ETOH
ALD up HDL down
Relative
Tabaco
```
62
Elephant sitting on my chest, pain with exertion but goes away if they rest
Stable angina
63
chest pain at rest, it gets works with exertion
unstable angina
64
Pain at rest, blood flow reduce, cell began to die, usually longer time issues compared to unstable angina
NSTEMI
65
100% block of blood flow to the myocardium and all cells die
STEMI, infarction
66
JVD, Edema if lower E's, HOTN, lungs are clear, low HR sinus bradicardia
right ventricular MI
67
cold extremities pulmonary edema, HOTN, skin conditions due to lack of oxygen, reflex HR were will be elevated to compensate.
left ventricular MI
68
What medication is good and first to inhibit thrombosis ?
Aggressive anticoagulation with Lovenox 1mg/kg SC q 12 hours OR
(3) Heparin: 80 units/kg IV loading dose, then initiate continuous infusion
18 units/kg/hr.
69
turbulence blood flow, higher velocity, decrease viscosity and blood flow against a incopetente valvue is the characteristics of what heart sound
Murmur
70
when auscultating the aortic valve what conditions are you looking for?
aortic stenosis murmur
aortic regurgitation murmur
coartic aorta
71
when listening to pulmonary valve, what valve condition are you listening for and what sound
regurgitation
stenosis
murmurs
72
Loud S2 suggests
hypertension, valve disorder, stenosis, or fluid.
73
Ventricular septum disease is detected in what valve
tricuspid
74
Loud S1 during auscultation indicates
increased blood velocity, mitral stenosis, heart block,
| hypertension, or calcification of mitral valve.
75
Hepatic portal circulation starts and returns to the systemic circulation via the ....
blood drains from the gastro track and spleen into the hepatic portal vein, Is then delivered to the liver to be process and absorb substances from the GI tract.
Blood returns to systemic circulation through the hepatic vein.
76
deep veins
(a) Radial veins: Drain lateral aspect of forearm.
(b) Ulnar veins: Drain medial aspect of forearm.
(c) Brachial veins: Drain forearms, elbow joints, and arms.
(d) Axillary veins: Drain arms, axillae, and upper part of chest wall.
(e) Subclavian veins: Drain arms, neck, and thoracic wall.
77
Superficial veins
(a) Cephalic veins: Drains the lateral aspect of upper limb.
(b) Basilic veins: Drain medial aspect of upper limb.
(c) Median antecubital veins: Drain palms and forearms.
78
which veins drain blood into the heart
inferiour, superior vena cava, coronary sinus
79
Definitive treatment for arrhythmia
catheter ablation
80
Subclavian arteries divide further into
Axillary, Brachial, Radial, Ulnar
81
Thoracic aorta branchs into
Bronchial, esophageal, Posterior, intercostal arteries, Superior phrenic
82
what artery supplies to lateral portion of forearm, wrist and hand
Radial artery
83
what supplies to the medial portion of forearm, wrist and hand
Ulnar artery
84
What artery supplies the superior and posterior surfaces of the diaphragm
superior phrenic arteries
85
Abdominal aorta branches out into?
celiac trunk
86
Celiac artery splits into?
Inferior phrenic artery, common hepatic artery, left gastric, splenic (spleen, pancreas, and stomach)
87
Gonadal artery branches into
testicular arteries and ovarian arteries
88
Supplies blood to lower limbs
External iliac arteries
89
what artery supplies blood to the pelvis ?
Internal iliac arteries
90
Pressure generated pushes blood in one direction to the right atrium where the pressure is approximately ?
0mm hg
91
main veins that drain blood from the head
internal jugular, external jugular, vertebral veins
92
Superficial veins MBC
mediam anticubital veins
basilic veins
cephalic veins
93
Deep veins
Radial, ulnar, brachial, axillary, subclavian
